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Magnesium is essential to many metabolic reactions, including
lipid metabolism, amino acid activation, the glycolytic cycle,
and the citric acid cycle. Its primary function is as an enzyme
cofactor, thus producing energy, synthesizing lipids and proteins,
regulating calcium flow and parathyroid hormone (PTH) secretion,
forming urea, and relaxing muscles. Vitamin B6 works with magnesium
in many enzyme systems and assists in the body's accumulation
of magnesium.
Magnesium is necessary to prevent the calcification of soft
tissue. This essential mineral protects the arterial linings
from stress caused by sudden blood pressure changes, and plays
a role in the formation of bone and in carbohydrate and mineral
metabolism.
A person with high blood pressure typically will have a lower
level of the mineral compared with somebody who has a healthier
blood pressure reading. Supplements work like a natural calcium
channel blocker, another standard antihypertension drug, but
without ill effects.
Excess insulin in the blood, low potassium levels, constricted
blood vessels-the nutrient addresses all of the condition's primary
causes simultaneously.
The use of magnesium supplements can help in the prevention
of cardiovascular disease by doing the following:
- Irregular heart rhythms become more stable.
- High blood pressure improves.
- The body keeps a better balance of potassium, another important
cardiovascular mineral.
- The heart pumps a larger volume of blood with no extra demand
for oxygen.
- Constricted blood vessels relax, allowing blood to flow more
freely.
- The chest pains of angina pectoris strike less frequently.
- By not allowing platelets to clump together, the blood becomes
less likely to form
artery-blocking clots.
- HDL cholesterol rises and LDL cholesterol falls.
The metabolism of sugar is linked to magnesium, making the
mineral essential to anyone with diabetes or insulin resistance.
Poor sugar control raises the risk of magnesium deficiency, which
then impairs sugar metabolism.
Persons with Type II diabetes can regulate blood sugar more
easily. As a result their need for oral diabetes drugs usually
diminishes and could disappear altogether. Persons with hypoglycemia,
too, can stabilize the rise and fall of their blood sugar.
For pregnant women, magnesium supplements can frequently overcome
several serious blood pressure disorders. Magnesium is the treatment
of choice for preeclampsia, a common complication seen in the
latter part of the pregnancy that raises blood pressure and causes
water retention, and can lead to coma.
Some 60 percent of all such hypertension-related complications
could be avoided, researchers estimate, if pregnant women were
to take supplements.
Mitral Valve Prolapes, which involves a weakness of a valve
in the heart, increases magnesium excretion. Resupplying the
mineral helps to correct low blood sugar, one of the main problems
linked to mitral valve prolapes, and counteracts fatigue, which
probably is the most frequently encountered symptom.
Taking magnesium orally is a good preventive for migraine
sufferers. People who enjoy the most prolonged relief from migraines
are usually those with the lowest blood levels of the mineral
(magnesium).
Magnesium is an effective treatment for the muscle and joint
pain related to Fibromyalgia. 300-600 mg, can help those suffering
from chronic fatigue syndrome. It's especially powerful when
combined with 1-2 grams of malic acid.
Magnesium readings are markedly lower than average in people
who have multiple sclerosis, Parkinson's, and Alzheimer's or
other types of dementia. Many of them have unusually high amounts
of aluminum in their brains, and the metal is known to interfere
with magnesium.
Magnesium is a key nutrient for preventing osteoporosis since
it balances the body's calcium supply and keeps it from being
excreted. Some scientists go so far as to say that how much magnesium
we eat is a stronger predictor of bone density than calcium consumption.
Without enough magnesium and other trace minerals, any additional
calcium we ingest will be deposited not around our bones, but
elsewhere, perhaps in the walls of our arteries.
Muscle growth and strength, especially from a weight-training
program, depends on magnesium.
Magnesium supplements can help tame premenstrual migraines
and yeast infections.
For better sleep magnesium should be a part of any nutrient
program. In addition to encouraging more restful sleep it works
against bruxism, an involuntary grinding of the teeth while asleep.
The additional benefits of magnesium supplementation are help
against chemical sensitivities, bacterial and viral infections,
leg cramps, kidney stones, and intermittent claudication, an
impairment in blood flow to the legs that causes pain upon exertion.
- Supplementary magnesium is available in several varieties
of salts.
- Magnesium citrate, magnesium gluconate, and magnesium lactate
are more soluble and bioavailable than magnesium oxide.
- Magnesium chloride is more soluble than magnesium oxide,
gluconate, citrate, hydroxide, and sulfate, and does not require
stomach acid for solubility, but its use is limited due to its
hygroscopic properties.
- Magnesium hydroxide (milk of magnesia)
- Magnesium sulfate (Epsom salts)
Deficiency: Risk factors for depletion include
gastrointestinal disorders, such as inflammatory bowel disease,
pancreatitis, fatty acid malabsorption, ileal dysfunction, and
gastrointestinal infections (viral, bacterial, or protozoan)
that result in malabsorption or vomiting and diarrhea; renal
dysfunction with excessive urine loss; nephrotoxic and diuretic
drugs; and endocrine disorders, such as hyperthyroidism, diabetes
mellitus, and hyperparathyroidism with hypercalcemia.
Depleting Agents: The consumption of alcohol,
the use of diuretics, diarrhea, the presence of fluoride, and
high levels of zinc and vitamin D all increase the body's need
for magnesium.
The consumption of large amounts of fats, cod liver oil, calcium,
vitamin D, and protein decrease magnesium absorption. Fat-soluble
vitamins also hinder the absorption of magnesium, as do foods
high is oxalic acid, such as almonds, chard, cocoa, rhubarb,
spinach, and tea.
Sources: Rich sources: tofu, legumes, whole
grains, green leafy vegetables, wheat bran, Brazil nuts, soybean
flour, almonds, cashews, blackstrap molasses, pumpkin and squash
seeds, pine nuts, black walnuts. Good sources: peanuts, whole
wheat flour, oat flour, beet greens, spinach, pistachio nuts,
shredded wheat, bran cereals, oatmeal, bananas, baked potatoes
(with skin).
Herb Sources: Many herbs, spices, and seaweeds
supply magnesium (e.g., agar seaweed, coriander, dill weed, celery
seed, sage, dried mustard, basil, cocoa powder, fennel seed,
savory, cumin seed, tarragon, marjoram, poppy seed).
Precautions: Individuals with severe heart disease
(such as high-grade atrioventricular block) should take magnesium
only on the advice of their physician.
Individuals with kidney disease should not take more than
3,000 mg per day.
Overuse of magnesium hydroxide (milk of magnesia) as a laxative
or antacid, or magnesium sulfate (Epsom salts) as a laxative
and tonic, may cause deficiencies of other minerals or lead to
toxicity.
Dosage Ranges and Duration of Administration: Recommendations
for adequate magnesium intake promulgated by the Food and Nutrition
Board of the Institute of Medicine in 1997:
Infants:
- Birth to 6 months: 30 mg/day
- 6 months to 1 year: 75 mg/day
Children:
- 1 to 3 years: 80 mg/day
- 4 to 8 years: 130 mg/day
- 9 to 13 years: 240 mg/day
Adolescents:
- 14 to 18 years (boys): 410 mg/day
- 14 to 18 years (girls): 360 mg/day
Adults:
- 19 to 30 years (men): 400 mg/day
- 19 to 30 years (women): 310 mg/day
- 31+ years (men): 420 mg/day
- 31+ years (women): 320 mg/day
Pregnant women:
- Up to 18 years: 400 mg/day
- 19 to 30 years: 350 mg/day
- 31 to 50 years: 360 mg/day
Lactating women:
- Up to 18 years: 360 mg/day
- 19 to 30 years: 310 mg/day
- 31 to 50 years: 320 mg/day
These represent significant increases for adolescents and
adults from the recommended dietary allowance promulgated by
the National Academy of Sciences in 1989. Supplementation should
be in small doses three to six times throughout the day with
a full glass of water to reduce chance of diarrhea.
INTERACTIONS
Alendronate; Tiludronate
Magnesium salts or magnesium-containing antacids interfere with
absorption of tiludronate, a bisphosphonate drug similar to alendronate.
This interaction has not been reported with alendronate. However,
calcium and other minerals should be taken at least two hours
before or after alendronate administration to minimize interference
with the absorption of the drug.
Calcium Channel Blockers
Magnesium sulfate may interact with calcium channel blockers
and decrease cardiac function, particularly in pregnant women.
However, another report indicates that using magnesium-enriched
salt as a substitute for sodium enhances the cardiovascular effects
derived from the combination of low dose felodipine and ramipril
in rats.
Digoxin
Hypomagnesemia increases the risk of cardiac glycoside toxicity.
Digoxin decreases the reabsorption of magnesium from the kidneys,
which leads to increased excretion in the urine. However, adequate
amounts of magnesium enhance the antiarrhythmic activity of this
drug, particularly by diminishing the ventricular response during
atrial fibrillation. One case report describes a patient with
digoxin toxicity associated with ventricular tachycardia. Treatment
with magnesium sulfate (two doses of 10 mmol IV) resulted in
a more stable junctional rhythm. Normal magnesium levels should
be maintained during digoxin treatment.
Estrogens; Progestins
In a controlled clinical study with 25 healthy women at or
past menopause and 15 healthy women of child-bearing age, serum
levels of magnesium were inversely related to the serum level
of estrogen in both groups. Another group of postmenopausal women
treated with conjugated estrogens and medroxyprogesterone for
one year had reduced urinary excretion of zinc and magnesium.
The clinical significance of this interaction is unknown.
Glipizide; Glyburide
Concomitant ingestion of magnesium hydroxide with both glipizide
and glyburide has been shown to increase the rate and extent
of absorption of these medications. The faster rate of absorption
may result in increased early insulin and glucose responses.
This effect was observed with magnesium hydroxide antacids, not
dietary supplements.
Insulin Preparations
Supplementation with magnesium in patients with type II diabetes
mellitus enhances insulin sensitivity and secretion. In rats
predisposed to type II diabetes, supplementation with oral magnesium
diminished the progression of the disease.
Nitrofurantoin
Magnesium salts decrease the rate and extent of absorption
of nitrofurantoin. It is not known if dietary supplements containing
magnesium will have a similar effect on nitrofurantoin absorption.
Penicillamine
Penicillamine can inactivate magnesium, particularly when
high doses are used over a long period of time. However, supplementation
with magnesium and other nutrients in over 50 patients on penicillamine
therapy for the treatment of autoimmune disorders resulted in
fewer adverse reactions than those commonly experienced in patients
treated with the drug alone.
Quinolone Antibiotics
Quinolone antibiotics form chelates with metal cations, such
as aluminum, magnesium, calcium, iron, zinc, copper, and manganese,
which significantly reduces the absorption of these medications.
Dietary supplements and antacids containing aluminum and magnesium
should be taken two to four hours before or after administration
of these antibiotics.
Tetracycline Derivatives
Tetracyclines form chelates with divalent and trivalent cations,
including iron, aluminum, magnesium, and calcium. It has been
reported that these chelates are poorly soluble and can significantly
reduce the absorption and efficacy of tetracyclines. However,
one study reports that magnesium-tetracycline complexes may be
more bioavailable than uncomplexed tetracycline due to a higher
degree of membrane diffusion.
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